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A 'weekend effect' in operative emergency general surgery.

Justin S Hatchimonji1, Elinore J Kaufman2, Catherine E Sharoky1

  • 1Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.

American Journal of Surgery
|November 21, 2019
PubMed
Summary
This summary is machine-generated.

A weekend effect in emergency general surgery increases patient mortality but not complications or failure-to-rescue. This study analyzed data from over 400,000 patients to identify surgical outcomes.

Keywords:
Emergency general surgeryFailure-to-rescueMetricsQuality improvement

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Area of Science:

  • Surgery
  • Health Services Research
  • Patient Outcomes

Background:

  • The existence of a
  • weekend effect
  • in emergency general surgery (EGS) is not well-established.
  • Previous research suggests potential disparities in care during weekends.

Purpose of the Study:

  • To investigate whether weekend operations in EGS are associated with higher rates of complications, mortality, and failure-to-rescue (FTR).
  • To identify specific factors contributing to any observed weekend effect in EGS outcomes.

Main Methods:

  • Utilized data from the National Inpatient Sample (NIS) between January 2014 and September 2015.
  • Identified 438,110 EGS patients, with 103,450 undergoing weekend operations.
  • Employed survey-weighted multivariable regression analyses to assess outcomes.

Main Results:

  • No significant association was found between weekend EGS operations and failure-to-rescue (FTR) or complications.
  • A statistically significant
  • weekend effect
  • was observed for mortality (OR 1.22; 95% CI 1.02-1.46).
  • An interaction between weekend operations and teaching hospital status influenced complication rates.

Conclusions:

  • Evidence supports a
  • weekend effect
  • on mortality in emergency general surgery.
  • No significant weekend effect was detected for complications or failure-to-rescue in this cohort.
  • Teaching hospital status modifies the impact of weekend operations on complications.